tumors of the lung, pleura and head and neck Flashcards
most common cause of lung cancer
smoking
along with small carcinoma, ____________ has the strongest association with smoking
along with small carcinoma, squamous carcinoma has the strongest association with smoking
squamous cell carcinoma will present usually a _____ lesion in/near major bronchi
central
precusor lesions of invasive squamous cell carcinoma arise from the
bronchial epithelium
most common type of lung cancer in US
adenocarcinoma
adenocarcinoma usually located
peripherally
hystologically defined by gland, tubule, and papilla formation and/or mucin production
adenocarcinoma
TTF-1 immunohistochemical stain shows
nuclear positivity in tumor cells
TTF-1 immunohistochemical results: - squamous cell carcinoma - adenocarcinoma - small cell carcinoma
- squamous cell carcinoma- negative - adenocarcinoma- positive - small cell carcinoma- positive
which lung cancer is very aggressive and usually presents at an advanced stage
small cell carcinoma
small cell carcinoma has frequent
paraneoplastic manifestations
small cell carcinoma usually presents as a
large central mass
small blue cells
small cell carcinoma
small cell carcinoma cells show
neuroendocrine differentiation
lung cancer prognosis depends on
tumor stage: TNM and type
is it important to histologic type lung cancers?
yasssssss, we can do targeted lung cancer therapy
pleural tumors usually arise from?
other sites, metastases
tumors involving the pleura may give rise to
pleural effusions
pleural plaques
most common manifestation of asbestos exposure
tumro derived from mesothelial cells that line the pleura and peritoneum
mesothelioma
mesothelioma is strongly associated with -timeline
asbestos exposure and develops after a long latent period
tumors is diffuse, rind-like growth over the pleura and it is firm and white
mesothelioma
mesothelioma is hard to distinguish from
adenocarcinoma
tumors of the oral cavity and oropharynx are mostly
squamous cell carcinoma
erythroplakia vs leukoplakia
red vs white precursor lesion
eisk factors for tumor in mouth
- smoking - alcohol abuse - HPV - sun exposure
strong association with epstein barr virus
nasopharyngeal carcinoma
most common presentation in nasopharyngeal carcinoma
upper cervical lymphadenopaathy
naso pharyngeal carcinoma histologic types - nonkeratinizing undifferentiated carcinoma - keratinizing squamos cell carcinoma - basaloi dsquamous cell carcinoma
- nonkeratinizing undifferentiated carcinoma –> strong association with EBV - keratinizing squamos cell carcinoma –> weak association with EBV
most carcinoma of the larynx are
squamous cell carcinoma
risk factors for larynx tumors
- smoking - alcohol - HPV

keratin stain nasopharyngea

nonkeratinizing undifferentiated carcinoma tumor cells- nasopharyngeal

mesothelioma

pleural plaque

small cell carcinoma

adenocarcinoma

squamous cell carcinoma

squamous cell carcinoma

squamous dysplasia in squamous cell carcinoma

squamous metaplasia in squamous cell carcinoma
can you operate on small cell cancer?
not really, they are aggressie in nature thus they are identified late in the game and too late to do surgery on them
Non-small cell lung cancer is usually found in the
parenchyma
rapid doubling time, high growth fraction, and the early development of widespread metastases.
small cell lung cancer
neuroendocrine tumor
small cell lung cancer
survival rates for small cell cancer is good
false: after one year survival rates drop to abysmal levels
- 20-30% of lung cancers
- Was most common histologic type until mid 1980s
- More commonly central / airway
Squamous (Epidermoid)
glandular tumor
adenocarcinoma
tumor that shows on CT a ground-glass appearance
adenocarcinoma in situ
common nodal involvment and early metastasis
adenocarcinoma
3 major presentation routes
- symptomatic- too late
- screening- often found early
- incidental finding
pancoat tumor
known as the superior sulcus tumor usually a squamous cell cancer and beucase of its close to the lung it will have symptoms that are related
bone pain
metastases
focal neurological defects
brain metastases or spinal cord compression from tumors in spine
paraneoplastic syndromes more common with
small cell lung cancer
small cell lung cancer is associated with which ab mediated neurologic sydnrome
lamber-eaton
CXR a good screening modality for lung cancer screening?
nope
national lung screening trial
led researchers to find that low-dose CT screening of lung cancer reduced mortality of 20%
relationship between nodule size and likelihood of malignany on chest CT
increases with size
TNM
T: tumor size
N: regional lymph nodes
M: distant metastasis
Workup of a pulmonary nodule (<___cm) or pulmonary mass (≥ ___cm)
Workup of a pulmonary nodule (<3 cm) or pulmonary mass (≥ 3cm)
what does PET shows?
abnormal metabolic activity with uptake of FDG radiotracer
mediastinoscopy is used to
pathologic stage of N2 and N3 nodes
EBUS used to
pathologic staining of N1, N2 and N3 nodes and even biopsy primary mass if it is located centrally
brain imaging what is preffered?
MRI; brain is often the first site of metastatic spread of lung cancer
SBRT
used for patient athat are not surgical candidates; delivers high dose radiation at different angles to the tumor- small collateral damage
stage for surgery is the primary option
Stage 1 and 2
immunotherapy is urrently used for
stage 4